A Journey to the Hills

The Aloka Vision Programmeprovides people in unserved rural areas of India with eye and vision care. In 2018,“eye camps“were set up in the Indian Himalayan Region – and the local inhabitants graciously accepted the assistance.

The air is thin once you reach “the Hills,” as the Himalayas are called in India. The land is bare, and the sky feels closer than anywhere else on Earth. Visiting this difficult-to-reach region, you feel as if you were leaving the old world behind and setting out on a true adventure. Frequently the Aloka team embarks on a “yatra” – as a journey for a good purpose is called in India – and in 2018 two Yatras led to the Himalayan region in the northern India.

“We didn’t know what to expect. I felt something special working with the people there in Uttararkhand. They accepted our offer to help. They are not used to someone taking care of them. And once we were done, they wanted to know if we would come back,” says Dr. Premjeeth Moodbidri.

800 people had their eyes tested.

People were examined with modern instruments.

An ambitiousproject

Moodbidri is the manager of the Aloka Vision Programme. He accompanied the expeditions in April and June 2018 with his team of optometrists, accompanied by eye doctors from a partner university. Aloka worked together with the Department of Ophthalmology at the Himalayan Institute of Medical Science, Swami Rama Himalayan University in Dehradun and the NGOParvitiya Jan Kalyan Sansthan. “The most important part of providing basic eye care is to treat the people as customers,” says Moodbidri. “They should be able to pick out a pair of glasses and must be shown respect. We are there to help, not treat them as supplicants.”

The camps are held in schools or public buildings. For one eye camp, the local muezzin summoned people from the minaret, a quick way to reach the local population. All the patients were asked about their education, working conditions, socioeconomic situation and access to medical care. “It was a linguistic challenge, but we had volunteers from the region, native speakers for all languages and dialects,” explains Moodbidri.

Right eye, left eye: 70 percent of the patients needed glasses.

The risk of cataracts

“I organize the eye camps on a regular basis, together with medical students and optometrists from the institute, to examine patients for cataracts or damage to the retina,” says Professor Renu Dhasmana from the Himalayan Institute of Medical Science in Dehradun. NGOs and volunteers from the region are also involved. “The logistics are challenging. You have to remember that we need to perform hundreds of eye exams in a short amount of time.”

During the visits in April and June, more than 800 patients were given eye and vision exams and – if necessary – received a pair of glasses with corrective lenses. They also took part in a field study called “UVProtect.” Some background information: there is a considerably higher risk of developing a cataract because of the ultraviolet radiation at high altitudes up in the mountains. The Himalayan Institute at Dehradun University, the ZEISS Vision Science Lab at the University of Tübingen and the Aloka team undertook this study together.

The Aloka Yatra thus also generated new findings that benefit both locals and researchers. According to the WHO, 20 percent of cataract cases result from UV radiation. The UV factor in the Himalayan region ranges between 6 to 11, while in Europe it is only 3 to 5. “UV radiation impacts the people living in the mountain valleys of the Himalayas especially,” says Moodbidri from Aloka.

Dr. Premjeeth Moodbidri explaining the treatment to his patients.

The “eye camps” were set up in schools and other public buildings.

Total eye and vision care matters

Often either just a cataract screening or a vision test is offered by “eye campers.” That means ophthalmologists provide cataract treatment but no glasses, or optometrists offer glasses but no cataract treament. Aloka emphasizes the need of total care, i.e. whenever possible, patients get what their eyes need. In June, for instance, 70 percent of all patients 40 years and older needed eyeglasses, while 30 percent required cataract surgery or a detailed retina screening. Literally everyone was in need of help with his or her sight and eyes. “It’s important that we examine each person’s eyes to determine if they need glasses and to diagnose potential eye diseases. The locals saw this as a service. For us, it’s a responsibility,” says Moodbidri. It helped that the ophthalmologists and optometrists worked together as a team. Nobody was sent away.

Everybody at Aloka can agree that offering this service to improve patients’ quality of life is the right way forward. There is a shortage of ophthalmologists and optometrists in the world, making it particularly important to provide information on good eye health. People need to know that a cataract can cause blindness, and that defective vision gets worse over the years. Moodbidri considers the eye camps a success: “We have to repeat them and continue our work there. That’s why Aloka always partners with local organizations to ensure frequent follow-ups.” It would also help if local structures could be developed to make the work sustainable. An integral part of the Aloka Vision Programme therefore is always to train locals, who then promote eye and vision care in their communities, perform simple vision tests and encourage people to attend eye camps.